Re: [Gnumed-devel] How to make the paper to EMR transition?

[James Busser]

On 13-Aug-08, at 11:16 AM, Rogerio Luz wrote:

What I would like to know is how did the practisioners out there make the transition from paper records to EMR.

Most doctors possess some kind of electronic index of their patients. commonly from billing or scheduling systems, and from which they will try to at least "seed" their EMR with a list of patients to whom care had been provided. Minimum "ported" information may be the patients' names, dates of birth, sex (gender), possibly their health insurance number(s), and possibly additional names (aliases) if these were supported in the source system. Possibly the dates of first service and last service (but note GNUmed does not at the present time hold any appointment information.)

The above depends on being able to get this information out of the old system, without having to pay ridiculous charges, and getting it in a form that will go into the new EMR.

The options by which to transfer and import the data would be in a "batch" mode, or on an as-needed basis if an individual patient's data can be exported, and then imported into GNUmed, on demand. It is possible to define for GNUmed an importer template to understand the form and content of the external data. GNUmed also offers a "slave mode" if it is possible to get the source system to work with GNUmed. This is especially desirable if doctors are already using a billing or scheduling system that they may like to continue to use.

As far as how much more information to transfer from each chart, the options include getting the secretaries to transcribe summary information from inside each chart, if patients had summaries prepared. The alternative is to scan (e.g. into PDF) just the summary, or the entire chart, or anything in between the two.

Unless enough of the paper chart of each patient is scanned and able to be imported, it will be necessary to keep the paper charts available in a so-called "hybrid" model. Some doctors who move to an EMR use the first subsequent visit of each pre-existing patient to populate the EMR with a problem list and to identify "key pages" for scanning.

The transition can take between 6 months and two years. A lot of your processes (and those of the office staff) will need to be re-engineered.

Here is a link to a guide that is specific to my adjacent province of Alberta (in Canada) but a lot of it is generalizable:

http://www.cpsa.ab.ca/publicationsresources/attachments_policies/Transition%20to%20Electronic%20Medical%20Records.pdf